School anxiety



School Anxiety: Information for Schools and Professionals for early intervention with school anxiety

Barnet School Anxiety Group

The School Anxiety Group was formed to raise awareness about school anxiety for parents/carers, young people and professionals in Barnet. Group members were:

Core group:

Kim Price, Head of Pavilion Outreach Team

Jean Waitt *SENDIASS formerly Parent Partnership

Carole Wilding, Educational Psychologist, Sophie Driver from September 2017

Mary Helmore, Advisory Teacher

Main group:

Breda O’Neil, CAMHS manager

Trevor Orr, Education Welfare

Karen Ali, Programmes and Interventions, Youth and Community (Y&C)

Rory Wilson, Deputy Head Teacher, East Barnet School

Michaela Carlowe, Multi-agency Support Manager

Caroline Quinlan, Senior Family Support Practitioner.

Rhoda Ben Aroya / Julie Sykes, School Nursing

Annie Etherington, Manager Autism Advisory Team,

Additional input from Fran Conley, Deputy Head Teacher, All Saints C of E Primary School NW2. Thanks to Rory Wilson and Catherine Cox for piloting the Supporting School Anxiety Plan procedure at East Barnet.

*Special Educational Needs and Disability Information, Advice and Support Service (SENDIASS)

Introduction

Many children may become anxious about some aspect of school life at some point in their school lives. For some pupils, anxiety about a particular aspect of school life or home life may become overwhelming and sometimes the anxiety generalises to other aspects of school life.

When anxiety is acute and exists over a long period of time, this can adversely affect the pupil’s health and well being. Similarly, anxiety if not addressed can adversely affect academic progress, the pupil’s overall ‘engagement’ with school may deteriorate, and attendance may decline. Anxiety is often behind difficulties with attendance and can affect arrival time at school. There may be signs in a pupil’s attendance patterns that all is not well.

This leaflet aims to:

➢ Increase awareness of school anxiety,

➢ Present a framework for early intervention with children having attendance difficulties linked to anxiety, and

➢ Provide a referral flowchart so that appropriate professional support may be obtained promptly.

About school anxiety

Terminology

There are many terms used by professionals for this difficulty. ‘School phobia’ is a term often used by medical professionals and ‘school refusal’ implies a child who won’t attend rather than can’t). School anxiety is the preferred term here. Anxiety about things is common in everyday life, and is something that it is possible to learn how to manage over time.

What to look out for

Change of school is a key time when problems can arise. For example at primary-secondary transfer when the child has not yet developed relationships within school, with staff or with other pupils. Below are some times of key vulnerability.

➢ A pupil who is failing to engage with school, school staff or peers, where there are no signs of improvement,

➢ A recent change of school, or any other transition,

➢ A pattern of late arrivals and absences for minor ailments,

➢ A pupil with disturbed sleep patterns or difficulty getting to sleep,

➢ Possible avoidance patterns: a pupil who visits the medical room frequently or leaves class for the toilet frequently and for extended periods,

➢ A pupil with regular attendance who is unable to attend lessons,

➢ A pattern of absences at the beginning and end of term and/or half term,

➢ Changes in attendance e.g. reduction from 100% attendance or reduction in number of lessons attending

➢ A pupil with limited social links,

➢ A withdrawn or very shy pupil who is hard to get to know, particularly where there are concerns about attendance or arrival time,

➢ Apparent unhappiness over the long term, for no identifiable reason,

➢ Any child who is reporting bullying where anxiety is shown both at school and at home,

➢ A return to school following a period of illness,

➢ A return to school or attendance at school when there has been a traumatic event (e.g. bereavement, divorce, or a parent/carers’ illness (young carers)

➢ New learners, refugees/asylum seekers or other pupils with English as a Second Language.

Supporting Pupils with School Anxiety and Attendance Difficulties- Key Professionals

Described below are the professional groups who could be involved and how they might work with schools and families where there is school anxiety with attendance difficulties.

Schools

A key staff member in each school monitors attendance and should advise the appropriate staff (class/form teacher, year head, and inclusion manager/ special needs coordinator) of the need to monitor a pupil’s attendance levels closely and discuss with pupil and parent/carers. All internal staff should be aware who this is and external professionals should be given this person’s name and role.

Education Welfare Team and Youth + Community

School attendance problems in primary schools involve the Education Welfare Team. In secondary schools, attendance becomes the responsibility of the Youth + Community when a referral is made by the school and barriers to engagement can be identified.

Children with a range of anxieties and emotional issues come to the attention of Education Welfare Officers (EWOs) and Youth + Community (Y+C) because of their poor school attendance. Sometimes, attendance problems are an early indication that there is a problem that needs a wide range of expertise to resolve. EWOs and Y+C Workers seek pupils’ reintegration into education, engaging with schools, other professionals, parent/carers and children to achieve the most positive outcomes. Y + C workers will identify barriers to engagement

School Nurses

School nurses’, main remit is usually signposting or referral onto other agencies. They liaise with school and parent/carers where there are medical and related issues and may liaise with GPs with the permission of the family. Apart from initial assessments, they do not hold these cases.

Educational Psychology Team

The EP works with a group of schools at all age levels, advising where there are concerns about a pupil, whether learning, physical, or related to emotions and behaviour. They take referrals from schools. Where there are attendance concerns they may liaise with a wide range of other professionals. For assessing the function of school anxiety, schools can access the School Refusal Assessment Scale (SRAS) (see Appendix 8) via the allocated EP.

If learning difficulties could be a factor in school anxiety, the EP might work with school and parent/carers to identify what would help the child’s learning, and advise on facilitating better levels of attendance for a particular pupil. If there are social, emotional or behavioural difficulties affecting the pupil’s learning or time in school the EP might meet with school and parent/carers, observe in or out of class, and/or advise schools on the best way forward. EPs sometimes see older pupils to explore the factors in poor attendance and the pupil’s perspective on these. They do not usually offer long-term work with children or families.

CAMHS in Schools / Child and Adolescent Mental Health Service (CAMHS)

CAMHS in Schools workers regard the approach of helping the child/young person and family as a step by step process, involving partnership with the parents, the school and other agencies in a way that is both holistic and tailored to the individual child’s needs.

When school anxiety is brought to their attention during a consultation, they would offer an initial meeting where the main issues and anxieties can be explored. This is often followed by short-term support, where appropriate, delivered at school over four to six sessions. This helps to assess whether a more intensive level of service is required, in which case they would refer on via their link with clinic-based CAMHS.

Barnet Special Educational Needs Disability Information, Advice and Support Service (SENDIASS) formerly Parent Partnership

Barnet SEND Information, Advice and Support Service offers free, confidential, and impartial Information, advice and support for parents/carers of children with special educational needs (SEN) and/or a disability and young people with special educational needs and or a disability.

The service is available to all young people or parents of children with a SEN and/or disability, between the ages of 0 and 25 years that live in the borough of Barnet.

Advisory Teacher for Autism

When a pupil has a diagnosis of an autism spectrum condition, some of the anxiety may be related to the condition. An advisory teacher specialising in autism will be involved in advising school on ways of managing or minimising anxiety for the child. Over time the child/young person will be helped to learn how to reduce their anxiety levels so that they can learn to manage these.

Specialist team

Additional support and advice is available to schools, professionals, parents and carers where children have defined medical or physical needs. These advisory teachers cover visual impairment, hearing impairment, and physical disabilities/complex medical needs and have community occupational therapists in the team. They may suggest strategies to reduce school anxiety in specific cases.

General Practitioner GP

Where a pupil shows high levels of school anxiety that are affecting their health and school attendance, the school nurse may liaise with the GP, the professional with a key role in supporting the family with medical issues.

The Early Intervention Framework

School Anxiety Support Plan (SASP) provide an early intervention framework involving a positive planning to improve a pupil’s attendance. The plans perform a similar function to forms already used by Educational Welfare or Youth + Community Workers but are designed specifically to address underlying attendance issues for pupils with school anxiety. They help the anxious young person, his/her parent/carers and key school staff to identify positive times and particular areas of difficulty and move forward in a positive way.

Patterns of attendance difficulty where there is school anxiety

What to do when attendance declines:

When attendance data, attendance in lessons and parental concerns highlight the presence of school anxiety, a first step is to arrange a meeting between school, parent/carers and pupil either in school or occasionally in the home. This is an opportunity to explore the underlying issues and identify possible solutions to improve matters. The SASP Framework provides a structure for exploring the issues and making an explicit action plan.

What to do when there is a total breakdown in attendance:

If attendance has completely ceased, it is vital that the parent/ carer takes the child to the family GP and seeks a referral to CAMHS or the school can refer to CAMHS. A medical consultant’s report is required if additional teaching is to be provided.

Flow chart of the Early Intervention Framework

The flow chart shows the early intervention cycle to improve school attendance by identifying and addressing the factors underlying the child or young person’s anxiety.

Helpful resources

Organisations

Barnet Young Carers and Siblings (BYCAS)

young-carers-2/

Young Minds

.uk

Kidscape

Helping children to prepare for school transition



Assertiveness training for children

Positive Assertive Confidence Skills (PACS) is (no longer free a Leaflet is available via Kidscape or the link below:



Mindfulness

Access to materials is no longer free.

Relax Kids



The Child Exploitation and Online Protection Centre (CEOP) is partnered with anti-bullying charity Beatbullying

See their information resource for targeted groups of children



Information about school anxiety issued by other local authorities

Northamptonshire Booklet

This is accessible via the Northamptonshire Mental Health Gateway asknormen.co.uk .

Scroll down and search the term ‘Anxiety’. A box will come up with a link to the booklet ANXIETY: Tackling It Together. The booklet includes a simplified section based on the principles of Cognitive Behaviour Therapy (pp. 3-8) and some useful checklists at the end.

West Sussex



Books

For parents:

‘Overcoming Your Child’s Fears and Worries: A self help guide using cognitive behavioural techniques’, by C. Creswell and L. Willetts (2007). London: Robinson

‘Helping Your Anxious Child: A Step-by-Step Guide for Parents’, by R. Rapee, S. Spence, V. Cobham and A. Wignall (2000). Oakland, CA: New Harbinger Publications.

For professionals:

‘Understanding School Refusal – a handbook for professionals in Education, Health and Social Care’, by M. Thambirajah, K. Grandison and L. De-Hayes (2008). London: Jessica Kingsley.

Queries

Should you wish to discuss anything in this document further please contact either Kim Price, Hospital and Outreach Providers of Education (HOPE) Sophie Driver, Educational Psychologist, or the school’s educational psychologist.

List of Appendices

Appendix 1: Supporting School Anxiety Plan: Preparation for the meeting

Appendix 2: Supporting School Anxiety Plan: Meeting 1

Appendix 3: Review of Supporting School Anxiety Plan

Appendix 4: How to run a person-centred meeting

Appendix 1: School Anxiety Support Plan (SASP): Preparation for the meeting

|SCHOOL ANXIETY SUPPORT PLAN |

|PREPARATION FOR MEETING 1 |

|School: |

|Name: Year/class: |

|Date set for meeting: |

|Names of Parent/s / Carer/s: |

|Name and role of any additional professionals to be invited (e.g. EP or Primary/Secondary Project worker): |

|The Plan aims to: |

|• reduce anxiety about school |

|• improve attendance. |

|Ideally, create a person-centred meeting. Questions can be put on the wall and a flipchart used. In preparation for meeting: |

|Obtain a current print out of attendance data. |

|Have a reference copy of the young person’s timetable. |

|Have red, orange and green colouring pencils available. |

|Complete relevant background data on this sheet |

| Brief background and issues that may be affecting current attendance: |

|What was the pattern in primary school? How did child cope with transition? Changing schools or classes/Struggling to make |

|friends/Bullying /Competitive sporting activities/Pressure over achievement of grades in school/Family history of emotionally based |

|school refusal, anxiety, phobias, depression / Change in family set up, for example, birth of a new baby / Experience of loss through the|

|death of a parent, parental separation, parent hospitalised. |

|Attainment, Academic Strengths, Personal Qualities: ( NC levels, outside interests and successes) |

| Do you think this pupil has any additional or special educational needs that have not been identified? |

Appendix 2: School Anxiety Support Plan (SASP): Meeting 1

|SCHOOL ANXIETY SUPPORT PLAN |

|MEETING 1 |

|School: |

|Name: Year/class: |

|Date: |

|Names of all attendees at this meeting: |

| |

| |

| |

|The Plan aims to: |

|• reduce anxiety about attending school or returning to school |

|• improve attendance. |

|At the meeting: |

|Have a current print out of attendance data. |

|Have a reference copy of the pupil’s timetable. |

|Have red, orange and green colouring pencils available. |

|Have preparation sheet with background information and current levels of attainment |

| What do you each feel you want to happen for this meeting to be worthwhile? |

|Pupil: |

|Parent/Carer: |

|School: |

|Refer to preparation papers and highlight any key points |

|Brief background and issues that may be affecting current attendance: |

|Pupil Achievements, Academic Strengths, Personal Qualities and Attributes: |

|Do you think the child has any additional or special educational needs? |

| |

| |

| |

| |

| 1) Looking for any underlying issues — to be completed by the young person (with a trusted adult if needed): |

|On a scale of 1 — 10 where would you rate the seriousness of the problem? |

|1= is not a problem or worry for me to 10= makes me very anxious |

|Knowing it is a school day, waking up, saying good-bye and leaving home 1 ---------- 2 ---------- 3 --------- 4|

|--------- 5 -------- 6 -------- 7 --------- 8 --------- 9 ------ 10 |

|Making the journey into school and/or being at the school entrance 1 --------- 2 --------- 3 |

|--------- 4 --------- 5 --------- 6 --------- 7 --------- 8 --------- 9 --------- 10 |

|Sitting in lessons, understanding and completing the class work 1 --------- 2 --------- 3|

|--------- 4 --------- 5 --------- 6 --------- 7 --------- 8 --------- 9 --------- 10 |

|Sitting in lessons, and seeing the behaviour of other children in the class 1 -------- 2 --------- 3 |

|--------- 4 --------- 5 --------- 6 --------- 7 --------- 8 --------- 9 --------- 10 |

|Having free time at breaks and Iunch times and playing with other children 1 --------- 2 --------- 3 --------- |

|4 --------- 5 --------- 6 --------- 7 --------- 8 --------- 9 --------- 10 |

|Going to assemblies and /or into the dining hall and /or going to the toilet 1 --------- 2 --------- 3 |

|--------- 4 --------- 5 --------- 6 --------- 7 --------- 8 --------- 9 --------- 10 |

|Teachers: do they make you feel welcome and supported or anxious 1 --------- 2 --------- 3 |

|--------- 4 --------- 5 --------- 6 --------- 7 --------- 8 --------- 9 --------- 10 |

|Use this space to add or draw any other school based worries you have: |

| |

| |

| |

| |

| |

| |

| |

|2) Summary of student’s views: |

|What works well for you in school? |

| |

| |

|What is working less well for you in school? |

| |

| |

|What changes could make a positive difference? |

| |

| |

|3) Summary of parents’/carers’ views: |

|What works well for you in school? |

| |

| |

|What is working less well for you in school? |

| |

| |

|What changes could make a positive difference? |

| |

| |

|4) Summary of schooI’s views: |

|What works well for you in school? |

| |

|What is working less well for you in school? |

| |

| |

|What changes could make a positive difference? |

| |

| |

| |

|5) What additional support is needed? Could any of the following help? |

| |

|What could be done to make the journey into school feel better? |

|Would a reduced timetable or a later start/ earlier finish be helpful? |

|Look together at the child’s timetable - child may use red, amber, green to highlight difficult, OK and comfortable times in school day |

|Can there be a ‘safe haven’ / special place to go in school? |

|ls it possible for the child to have an ‘exit card’? |

|Who is the key member of school staff who will support the child/family? |

|Could a ‘buddy system’ give some extra support? |

|ls there a nurture group in school that could help? |

|Could some special work be prepared for times when the child is unable to be in class (to do in a quiet area/ library) |

|Could parents/carers prepare a study timetable at home when the child is not in school and keep to school hours including getting up |

|early)? |

|What else might help, for example, mentoring sessions? Relaxation exercises? |

|Could the child keep a daily log to track feelings for two weeks? |

|Which seating place is most comfortable for the child in each lesson? |

|Would the child like the teacher to speak to the class before the return? If so, what will be said? |

|Or how will the child answer questions about their absence? |

|How will parents and school acknowledge and praise improving attendance? |

|Review of anti-bullying policy and procedures. |

|Actions |By whom? |By when? |

| | | |

| | | |

| | | |

| | | |

| | | |

| | | |

| | | |

|Other notes: |

| |

| |

| |

Appendix 3: Review- School Anxiety Support Plan

|REVIEW – SCHOOL ANXIETY SUPPORT PLAN |

|MEETING NUMBER____ Outcome: Plan Number_____ |

|School: |

|Name: Year/class: |

|Date: |

|Names of all attendees at this meeting: |

| |

| |

| |

|The Plan aims to: |

|• reduce anxiety about school |

|• improve attendance. |

|In preparation for the meeting: |

|Obtain a current print out of attendance data. |

|Have a reference copy of the young person’s timetable. |

|Have red, orange and green colouring pencils available. |

|Complete relevant background data on this sheet |

|Looking at attendance pattern since School Anxiety Support Plan was agreed — has there been a change? |

| |

| |

| |

| |

|Summary of progress, issues and points arising from School Anxiety Support Plan |

| |

| |

| |

| |

| |

|1) Looking for any underlying issues — to be completed by the young person |

|On a scale of 1 — 10 where would you rate the seriousness of the problem? |

|1= is not a problem or worry for me 10= makes me very anxious |

| |

|Knowing it is a school day, waking up, saying good-bye and leaving home |

|1 --------- 2 --------- 3 --------- 4 --------- 5 ---------6 --------- 7 --------- 8 --------- 9 --------- 10 |

|Making the journey into school and/or being at the school entrance |

|1 --------- 2 --------- 3 --------- 4 --------- 5 --------- 6 --------- 7 --------- 8 --------- 9 --------- 10 |

|Sitting in lessons, understanding and completing the class work |

|1 --------- 2 --------- 3 --------- 4 --------- 5 --------- 6 --------- 7 --------- 8 --------- 9 --------- 10 |

|Sitting in lessons, and seeing the behaviour of other children in the class |

|1 ------—-- 2 --------- 3 --------- 4 --------- 5 --------- 6 --------- 7 --------- 8 --------- 9 --------- 10 |

|Having free time at breaks and Iunch times and playing with other children |

|1 --------- 2 --------- 3 --------- 4 --------- 5 --------- 6 --------- 7 --------- 8 --------- 9 --------- 10 |

|Going to assemblies and /or into the dining hall and /or going to the toilet |

|1 --------- 2 --------- 3 --------- 4 --------- 5 --------- 6 --------- 7 --------- 8 --------- 9 --------- 10 |

|Teachers: do they make you feel welcome and supported or anxious |

|1 --------- 2 --------- 3 --------- 4 --------- 5 --------- 6 --------- 7 --------- 8 --------- 9 --------- 10 |

|Use this space to add or draw any other school based worries you have |

| |

| |

| |

| |

| |

|2) Summary of young person’s views |

|Where has there been some improvement? |

| |

| |

| |

|What has stayed the same? |

| |

| |

| |

|Where does there need to be more change or improvement? |

| |

| |

| |

| |

|3) Summary of parents’/carers’ views |

|Where has there been some improvement? |

| |

| |

| |

|What has stayed the same? |

| |

| |

| |

|Where does there need to be more change or improvement? |

| |

| |

| |

| |

|4) Summary of schooI’s views |

|Where has there been improvement? |

| |

| |

| |

| |

|What has stayed the same? |

| |

| |

| |

| |

|Where does there need to be more change or improvement? |

| |

| |

| |

| |

|5) What additional support is needed? |

| |By whom? |By when? |

|Which working-well actions should continue from IAP Number --? | | |

|New actions | | |

| | | |

| | | |

| | | |

| | | |

|What are the next steps? |

|Has a referral to CAMHS in schools been made? |

|Would a CAF (Common Assessment Form) be helpful to create a professional team around the child? |

|Is additional input is required from the following agencies? E.g.: |

|Child and Adolescent Mental Health Service – CAMHS Tier 3 |

|Pavilion Outreach Team (see school website) |

|Educational Psychology Team – EPT |

|SEN Disability Information and Advice and Support Service (SENDIASS) (was Parent Partnership) |

|Youth + Community – Y+C |

|Intensive Family Focus –IFF |

| |

| |

| |

| |

| |

|Key Recommendations |

| |

| |

| |

| |Exit process and monitor with school and home based actions |

| |School to complete a CAF and set a ‘Team around the ChiId’ meeting, including referral/s to: |

| | |

| |Refer to Youth + Community / Education Welfare for consideration of Court Assessment |

-----------------------

Referral on via CAF or EWO/Y&C

Monitor

School Anxiety Support Plan (SASP) triggered

Home school pupil meeting based on form

Put plan in place

Monitor outcome

Plan to maintain

Reduction in child/young person’s attendance to school and/or lessons

Review Plan using ‘Reviewing SASP form’

Home-school-pupil meeting to review plan, explore and record what was helpful what was not helpful

Attendance improving

Attendance not improving

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